Provider Demographics
NPI:1376835587
Name:STEPHENSON, BEVERLY GAIL (DOULA)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:GAIL
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 SHAW RD
Mailing Address - Street 2:
Mailing Address - City:ROEBUCK
Mailing Address - State:SC
Mailing Address - Zip Code:29376-4203
Mailing Address - Country:US
Mailing Address - Phone:864-909-4566
Mailing Address - Fax:
Practice Address - Street 1:390 SHAW RD
Practice Address - Street 2:
Practice Address - City:ROEBUCK
Practice Address - State:SC
Practice Address - Zip Code:29376-4203
Practice Address - Country:US
Practice Address - Phone:864-909-4566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula